A new study from the George Washington University School of Public Health and Health Services (SPHHS) has looked at the relationship between health information laws and health system improvements for children and adolescents under Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit.

The researchers analyzed various health information laws like HIPAA (Health Information Portability and Accountability Act), state confidentiality laws, and other laws related to information privacy in schools, child welfare, and day care settings. What they found was that two issues in particular affect the exchange of information across systems of care that span schools and communities.

One is where the health information is stored, whether it’s covered by FERPA (Family Educational Rights and Privacy Act) or considered the record of a HIPAA Regulated Entity. The other issue is whether written consent is required. They found that HIPAA actually does not require consent if disclosures are for treatment, payment, and healthcare operations. As a result, the researchers say, a HIPAA Regulated Entity has more running room to disclose without consent.

“Access to health information by providers and caregivers across medical and educational settings is critical to ensuring children and adolescents receive coordinated, quality health care," lead author of the report Jane Hyatt Thorpe, JD, an associate professor of health policy at SPHHS, said in a statement. "While various federal and state laws governing health information are often construed as barriers, this analysis breaks down those barriers and highlights opportunities for effective information sharing across care teams and medical and educational settings."

The researchers say that in thinking about sharing this information it’s important to emphasize patient engagement on the part of families and adolescents. A guide addressing patient engagement in creating “treatment team” consent arrangements that span different care settings would go a long way, say the researchers.

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